Clinical presentation of splenomegaly at Kigali University Teaching Hospital, Rwanda - A retrospective descriptive study

INTRODUCTION: Splenomegaly is a common condition in malaria endemic region and is frequently associated with cytopenias. Splenomegaly is usually a clinical finding, but imaging studies have helped to assess for or confirm it. Evaluating the clinico-hematological presentation of splenomegaly at the biggest referral hospital in Rwanda would bring important information to the clinicians.
METHODS: This was a retrospective descriptive study conducted at Kigali University Teaching Hospital, medical department, for a period of one year. We reviewed patients’ charts admitted with the conditions known to be associated with splenomegaly referring to the available literature, and were enrolled if found to have it. Demographic, clinical, hematological, and radiological information was extracted, then descriptive analyses were performed.
RESULTS: A total of 1950 patients’ files were examined, and 117 (6%) patients had splenomegaly. The mean age was 39 years and women were predominant (55.5%). Many cases of splenomegaly were detected on admission (49.6%), at stages II (33.3%) and III (23.1%). Many patients had no symptoms of splenomegaly (30.7%), others had features of anemia (22.2%), and infection (25.6%). Abdominal ultrasound was the imaging of choice to evaluate the spleen size and has discovered splenomegaly in 28.2% of cases after the clinical examination was unremarkable. The main causes of splenomegaly were Hyper-reactive Malarial Splenomegaly (21.4%) and portal hypertension (19.6%).
CONCLUSION: Splenomegaly is a frequent condition and more prevalent in the eastern province, it was detected on admission at a moderate stage and associated with hemolysis in many cases